A healthy communication line

It is good to see the National Consumer Commission prescribe for the medical community what the good doctors themselves would probably never have ordered: culpability for “deficiency in service”. The apex consumer panel has ruled that if a doctor does not inform patients about the side-effects of medicines and the necessary precautions to be taken, the doctor will be held responsible. The court was deciding on the death of a 45-year-old man in 1993, who died after apparently following the wrong medication prescribed for diabetes by his doctor. Despite knowing that the patient was an alcoholic whose urine tests would lead to incorrect results, the doctor, according to the commission, jumped to the conclusion that he was diabetic. Worse, the physician then advised the patient a very sensitive drug without bothering to give the mandatory precautions.

This is a landmark case in India where the healthcare system is, to put it mildly, hardly in the pink of health. In a sense, the patients have only themselves to blame for seldom asking their doctors about the medicines they are prescribed. A vast number of Indians still see the doctor as a near-divinity who need not be questioned. There is no ‘one-size-fits-all’ treatment for any condition, and patients should work with those prescribing their medication. Only then can they determine which treatments will work best with their lifestyle.

But unfortunately, it is not uncommon for patients — especially the poor — who feel unable to discuss their concerns with their general physician, to stop taking medication without even informing him. If there is anything worse, it is the way most GPs fail to recognise the importance of patient involvement in treatment plans. Successful doctor-patient relationships depend on trust. To establish that trust doctors must respect patients’ right to decide whether or not to undergo a medical intervention even where a refusal may result in harm to themselves. Patients must be given sufficient information — in a way that they can understand — to enable them to exercise their right to make informed decisions about their care. And for that to happen, they must talk.